My current dilemma is causing me great anguish and sleeplessness. If anyone has any feedback, I'd really appreciate it.
I'm a 29 year-old R.N. with a B.A. in religious studies ('96) and a B.S.N. ('00). The last year and a half I worked on an med-surg/oncology in central Virginia for a small not-for-profit community hospital in central Virginia. In that position, I often took care of hospice patients and LOVED the experience. However, one of my greatest frustrations was having a mixed assignment consisting of, say, one or two hospice patients and three to four agressive care folks. The menial multiple task mastering that the latter group required always seemed to take precedence over the more amorphous spiritual and psychosocial care that hospice patients require. Bottom line: Next time I work with hospice patients, I want to work with just hospice patients for that particular shift.
Now, I just relocated to my parents' house in the N. Va. area to try to save money with which to afford a house down payment. I was just offered a FT position at an acute care inpatient hospice house at $21/hr. I was also just offered a FT position in telemetry at Georgetown at $23/hr plus a big sign-on bonus. I know I love, love, love, love hospice and find hospital inpatient treatment stressful and creatively tedius. Nevertheless, I'm tempted to take the Georgetown job for the following reasons: Experience, flexibility, and income. Here's why:
Some nurses have said that as the hospice field grows it will begin to encompass a wider variety of med-surg type cases. I recently even heard of an available Robert Wood Johnson grant to study the feasability of extending hospice and palliative care to ICU settings. A hospice nurse educator in the Charlottesville area is a psychiatric CNS, but she also works one day a week at U.Va.'s CCU and says she will "for the rest of her life" because it will keep her acute care skills current, which she finds very pertinent to her value as a hospice nurse.
Also, since hospice pays relatively less than inpatient fields (around here the FT salary cap is at around $60,000 after 15 years, barely enough on which to live inside the Capitol Beltway if you're single, like me) having up-to-date med-surg skills means being able to either moonlight or split my time 50-50 between hospice and better-paying inpatient work if I ever find myself cash-strapped. Within the N. Va. hospice organization the only advanced practice and therefore high-paying nursing positions are in management (unsure if that's for me) and staff training (which may be for me). The only problem with the prospect of becoming a staff trainer is that the N.Va. organization only employs two of them for an area consisting of 5 counties, so I imagine that competition for the positions is quite keen if they ever become open.
Sorry this was so long, but my situation and thinking is complicated and conflicted, and I need to make a decision soon. Thanks ahead of time for any feedback.